Individual
CORY FAGIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1039 NW JACKSONVILLE AVE, BEND, OR 97703-2345
(513) 709-4106
Mailing address
1039 NW JACKSONVILLE AVE, BEND, OR 97703-2345
(513) 709-4106
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/06/2019
Last updated
02/06/2019
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